Manual toothbrushing is the most widely-used oral hygiene practice and is recognized as an effective technique for removal of bacterial plaque. But it is generally agreed that typical toothbrushing techniques and conventional toothbrushes are successful at removing plaque only substantially from portions of the hard oral tissue, i.e., tooth surfaces. Soft oral tissue and the hard oral tissue just adjacent to it are generally not well-addressed by conventional toothbrushes. In particular, the free gingival margin of soft oral tissue, that is, the portion of gingivae that overlap the teeth crowns, and the gingival sulcular region, located between the free gingival margin and the teeth crowns, are not generally well-addressed by conventional toothbrushes. As a result, typical toothbrushing techniques promote removal of plaque from only the teeth surfaces above the gingival margin, while not adequately cleaning the gingivae and sulcular regions. Yet cleaning of the gingivae and sulcular regions is required to control periodontal disease.
A wide range of toothbrush configurations have been proposed for promoting cleaning of both hard and soft oral tissue through toothbrushing. For example, out-of-line toothbrush handle orientations and nonuniform toothbrush bristle configurations have been suggested. Although such configurations in general do typically achieve some gains in promotion of improved toothbrushing over conventional toothbrushes, they generally do not optimally enable proper cleaning of both soft as well as hard oral tissue.